Objective: To determine if oral brush biopsies from pre-malignant and malignant lesions could yield enough RNA for gene expression analysis, and explore its utility as a diagnostic test as an alternative to invasive incisional biopsies. Methods: In a subject with leukoplakia with dysplasia, a brush biopsy was taken from the right lateral surface of the tongue. The time was recorded and the subject was seen at the same time for the following two days and brush biopsies were taken from the same site at 24-hour intervals. The brush was rinsed into lysis buffer (RLT, Qiagen RNeasy minikit) and RNA was extracted as per the protocol. PCR amplification was conducted on the cDNA extract using an Epithelial Membrane Protein 1 (EMP1) primer. Further RNA amplification will to be conducted and the result taken to an Affymetrix genechip for microarray analysis. Results: A band was detected for EMP1 from the PCR for all the days, which illuminates the possibility of taking these results forward to an Affymetrix genechip to establish the group of genes differentially expressed in pre-malignant and malignant lesions. This will identify unique genes that may be used as diagnostic indicators and/or potential chemotherapeutic targets. Conclusions: RNA was successfully extracted from the exfoliated cells form the brush biopsy. Detection of the band for EMP1 following PCR amplification appears to have some potential for conducting gene expression studies which may have some utility with early diagnosis of pre-malignant and malignant lesions in the oral cavity. This may further the possibility for establishing a database for genetic analysis and therefore establish candidate genes which are differentially expressed in oral lesions.

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